Tag Archives: DOH

Litratong Pinoy: Proteksyon (surgical mask)

Hindi ako kadalasang nagtatabi ng surgical mask sa bahay. Para saan nga ba ang surgical mask na ito? Hindi po ito proteksyon para sa kumakalat na AH1N1 virus dahil hindi naman kinakampanya ng Department of Health ang paggamit nito bilang mabisang pangontra sa virus bagkus ang tamang kalinisan lamang at pagpapanatiling malusog ng katawan. Binili ko ang mask na ito noong April 10, 2003 (base sa nakatabi pang resibo) sa isang malaking hospital sa Quezon City na nadaanan ko galing sa opisina. Ginamit ko ito sa isang coverage noon sa Research Institute for Tropical Medicine sa Alabang, Muntinlupa City.

Naalala ko meron pala akong isa pang post tungkol sa proteksyon dito.

Punta lang kayo dito para sa ibang lahok ngayon Linggo.

Swine virus scare!

Source: DOH Media Office

THE Department of Health (DOH) clarifies that there are no reports yet of swine flu among humans in the Philippines in relation to the outbreak that originated from Mexico and other affected countries.

The government agency emphasizes that the H1N1 swine flu virus recently discovered in Mexico is an entirely novel strain.

Experts describe it as having an unusual combination of genetic material from pigs, birds and humans which have reassorted and caused the development of the current human H1N1 swine influenza virus.

This is the first time that such a virus has been isolated with evidence of human-to-human transmission. There is no available vaccine as of yet specific for this virus.

The World Health Organization alerted all its member states on April 25 that the outbreak has escalated into a “public health emergency of international concern.”

The DOH immediately stepped up its surveillance and biosecurity measures in all international and local airports to prevent the entry of the virus.

A total of 81 individuals have been killed in Mexico and possibly infected and unconfirmed number of other individuals in certain parts of other countries like U.S. and Canada.

The Bureau of Quarantine has already instituted precautionary measures in major ports and possible entry points of the virus in the country.

All quarantine stations are already implementing health surveillance measures including thermal scanning of all arriving passengers from countries with reported swine flu cases. Travelers will also be required to fill up a Health Declaration Checklist to screen for potential signs and symptoms and possible exposure to the virus.

A Health Alert Notice (HAN) on flu-like illness or Swine Influenza Virus (SIV) will also be distributed to all arriving travelers especially from the U.S. and Mexico. We will also convene another meeting with all stakeholders at our ports for a more heightened and coordinated response against the entry of the virus.

All DOH Regional Health Offices and local government units are requested to look out for influenza outbreaks, influenza-like illness (ILI) and /or atypical pneumonia in their areas of jurisdiction and to immediately report such cases to the National Epidemiology Center and/or the Health Emergency Management Staff. (DOH HOTLINE: 7111001 / 7111002)

The DOH Referral Hospitals for Emerging Infectious Diseases (EID) have also been primed to ready their facilities to receive patients confirmed or suspected to have been infected with the novel swine flu virus.

These referral centers include the Research Institute of Medicine (RITM), the San Lazaro Hospital and the Lung Center of the Philippines, all of which are equipped with negative pressure isolation rooms for managing patients infected with highly virulent and pathogenic microorganisms.

The DOH said it is gearing up to respond to and manage the potential entry of the H1N1 swine flu virus in the country. Sufficient number of Personal Protective Equipment (PPE) and the antiviral drug, Oseltamivir, are available and will be given to high-risk exposure groups which include frontline health workers and surveillance teams at the national and local levels.

Meanwhile, the DOH is advising the public that there is no travel ban being issued by this Department to Mexico and other affected countries.

Travelers are however asked to reconsider their plans to travel to Mexico and other affected countries unless extremely necessary.

As a precaution, the DOH recommends the following:

• Cover your nose and mouth with a tissue when coughing or sneezing.
• Wash hands regularly with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective
• Avoid close contact with sick people.
• If sick, self-monitor and stay home from work or school and limit contact with others.
• Consult your doctor immediately should signs and symptoms of flu persist.

My son’s brush with Kawasaki Syndrome

Five key symptoms aside from high persistent fever
(Photos taken from various sources on the internet)

SOME rare diseases that hit very young children come with ordinary signs and symptoms which when ignored could cause debilitating lifetime effects.

A few days before my five-year-old son, Khalil, was confined and diagnosed with a rare Kawasaki Syndrome in 2004, he developed a rash on his hands and feet.
I would have dismissed the signs as minor allergy. But the occurrence of abdominal pains, reddish eyes, dark red lips, and strawberry spots on Khalil’s tongue that accompany his swollen fingers made me suspect that he could be suffering from a condition worse than an allergy.

My son was full of energy despite the discomforts brought by these unusual symptoms.

I was nervous when I brought him to the pediatrician’s clinic anticipating the least serious diagnosis from the doctor.

When Dr. Annaliza Duran, a consultant at the FEU Hospital in Quezon City, saw my child she told me right away that something is wrong with the kid as she is familiar with his medical record since he was a baby.

“I don’t like his skin color (referring to Khalil’s pale yellowish skin at the time). I know when he is okay and when he is not,” Dr. Duran told me.

The then 39-year-old lady doctor initially said the symptoms are similar to disease-causing Streptococcus bacteria which are responsible for infections such as strep throat, scarlet fever, and some types of pneumonia.

Khalil’s grayish nailbed also indicate the poor entry of air in his lungs.
She recommended for my son’s confinement to find out what really ails him.

An X-ray made on Khalil at the hospital confirms her earlier diagnosis of pneumonia.

I thought that he would be sent home in a few days. But my worst fear happened on our third day at the hospital.

I received a phone call from Dr. Duran and slowly disclosed to me that aside from pneumonia, Khalil is also suffering from a rare Kawasaki disease.

I was stunned and could not control my tears when I heard what the doctor just said. I initially thought the disease was fatal and feel sorry for my son. I may have heard or read something about Kawasaki disease in the past, but never imagine one of my kids would develop it one day.

Even when doctors gave assurance that Kawasaki is not infectious, I still wonder how my child acquired such an ailment.

Doctors said there is no known cause of Kawasaki, but it could be associated to streptococcus bacteria.

Streptococcus bacteria are normally found in the human throat, respiratory tract, blood stream, and wounds. It is often airborne in hospitals, schools and other public places.

Dr. Duran and two other doctors, a consultant cardiologist and infectious disease expert also of FEU Hospital corroborated the impression of Kawasaki Disease based on clinical manifestations and laboratory analysis including CBC (complete blood count) and AFC (actual platelet count).

They said that most characteristics of Kawasaki were present on my child including the inflammation or swelling of hands, feet, whites of the eyes, mouth, lips and throat, fever, and swelling of the lymph nodes in the neck.

Khalil’s blood samples showed an increase in the number of white blood cells which normally multiply in the presence of an infection and elevated platelet levels.

He also had an elevated ESR or erythrocyte sedimentation rate. ESR is a measurement of how quickly red blood cells fall to the bottom of a test tube.
When swelling and inflammation are present, the blood’s proteins clump together and become heavier than normal. Thus, when measured, they fall and settle faster at the bottom of the test tube.

Doctors immediately prescribed an aspirin on my child to lessen the inflammation of many tissues that Kawasaki produces.

While the symptoms of Kawasaki run its course and resolve within a few weeks, it becomes a concern because the illness primarily affects the coronary or heart arteries which provide the heart muscle with an oxygen-rich blood supply.

The three doctors attending to my son recommended the immediate transfusion of Intravenous Immunoglobulin (IVIG) within 10 days to decrease the risk of heart and blood vessel complications.

Doctors said 10 to 15 percent of children afflicted with untreated Kawasaki developed heart problem.

“Medication is quite expensive, but we need to immediately transfuse IVIG the soonest possible time to avoid the setting in of possible complications particularly coronary heart disease,” Dr. Duran said.

Khalil needs to be transfused with 25 vials of 2.5 grams of IVIG. A vial costs a whopping P4,000 to P5,000.

On the ninth day (of the ailment), the medicine was transfused on my son for 21 uninterrupted hours.

My family and the doctors were praying that no side effects and rejection would occur during the course of transfusion.

Among the noted side effects of IVIG are fever, chill, and rashes.
We were thankful that Khali1 responded well to the medicine.

After ten long days, my son was finally given a clean bill of health by his doctors and was discharged of the hospital.

However, he needs to be regularly examined particularly by cardiologists to monitor if any heart problem has occurred after the illness.

I realized that no matter how well you keep your child away from dirt there is no guarantee that he is protected from acquiring certain types of diseases like the rare Kawasaki disease.

But with a timely consultation with your doctor, complications of specific ailments (that show ordinary signs and symptoms) could be prevented later on.


What is Kawasaki Syndrome?

Kawasaki syndrome (KS) was first recognized by Japanese physician Dr. Tomisaku Kawasaki in 1961.

It is a disease in young children with an unknown cause, giving rise to a rash, glandular swelling, and sometimes damage to the heart.

KS has replaced acute rheumatic fever as the leading cause of acquired heart disease in children in the United States (Asian or Asian American heritage) and Japan.

About 1,800 new cases are diagnosed in the US each year and the evidence is on the rise.

It is the most common form of vasculitis or inflammation of the blood vessel(s).
The heart, particularly the coronary arteries, is affected in as many as 20 percent of children with Kawasaki.

The disease can weaken the wall of one or more of the coronary arteries, causing it to bulge or balloon out. This weakened, ballooned area is called an aneurysm.

Blood clots can form in the ballooned area and possibly block the blood flow through the coronary artery. When this happens, the heart muscle will no longer receive an adequate supply of red blood, and the heart muscle can damaged.

The illness may cause the heart muscle (myocardium) to be irritated and inflamed, as well as the membrane covering the heart (pericardium). Irregular heart rhythms and heart valve problems may also occur with Kawasaki disease.

In most cases, the effects on the heart caused by KS are temporary, and heal within five or six weeks. However, coronary artery problems may sometimes persist for longer periods of time.

Early treatment of KS with aspirin and high-dose IVIG has proved to be effective in reducing clinical symptoms, as well as reducing the prevalence of coronary aneurysm.

The single-dose regimen for IVIG is now the standard recommended initial mode of therapy.

The disease was more prevalent in male children between 1 to 5 years old.
The most common symptoms of KS may include: moderate to high fever that rises and falls for up to three weeks; irritability; swollen lymph glands in the neck; spotty, bright red rash on the back, chest, abdomen, and/or groin; bloodshot eyes; sensitivity to light; swollen coated tongue; dry, red, cracked lips; dark red interior surfaces of the mouth; red swollen palms of hands and soles of feet; peeling skin around the nailbeds, hands, or feet; and swollen painful joints.

About 80 percent of all children have a full recovery after KS resolves.
Some heart problems may not be evident right away, so it is important to keep follow-up appointments with your child’s physician, even if your child is feeling well.

Meanwhile, the Department of Health said the country has no significant data of Kawasaki disease at present.

“Kawasaki is not infectious. It has unknown etiology (cause) and a not-reportable disease. But we have sporadic cases here in the Philippines,” said DOH medical officer Dr. Luningning Villa (she now handles the ASEAN Plus Three Emerging Infectious Diseases Programme).

My article came out in People’s Tonight in Nov. 2004